Early hospital admissions and later disturbances of behaviour and learning

This study provides strong and unexpected evidence that one admission to hospital of more than a week's duration or repeated admissions before the age of five years (in particular between six months and four years) are associated with an increased risk of behaviour disturbance and poor reading in adolescence. The children who have experienced these early admissions are more troublesome out of class, more likely to be delinquent and more likely to show unstable job-patterns than those who are not admitted in the first five years. They include a high proportion of poor readers, though this is partly explained by poor application to work in the classroom. In contrast, nervous, shy or withdrawn behaviour is not more frequently reported in adolescence among children who have had early hospital-admissions. The association of troublesome and socially difficult behaviour with early admissions is explained neither by the initial selection of children for hospital nor by the physical disabilities they sometimes carry in later life. The interpretation of this association is complicated by the fact that some pre-school children appear to benefit from hospital stay. The children most vulnerable to early admission are those who are highly dependent on their mothers or who are under stress at home at the time of admission. There is evidence that early admissions to hospital are more frequent today than 25 years ago and that re-admissions are more frequent. Although the length of stay has been greatly reduced, the proportion of children who experience 'long or repeated' admissions is no less than in 1946 and may be greater.